Form W-4 (2010) - Shared Services Home Page

Form W-4 (2010)Purpose. Complete Form W-4 so that youremployer can withhold the correct federal incometax from your pay. Consider completing a newForm W-4 each year and when your personal orfinancial situation changes.Exemption from withholding. If you areexempt, complete only lines 1, 2, 3, 4, and 7and sign the form to validate it. Your exemptionfor 2010 expires February 16, 2011. SeePub. 505, Tax Withholding and Estimated Tax.Note. You cannot claim exemption fromwithholding if (a) your income exceeds $950and includes more than $300 of unearnedincome (for example, interest and dividends)and (b) another person can claim you as adependent on his or her tax return.Basic instructions. If you are not exempt,complete the Personal Allowances Worksheetbelow. The worksheets on page 2 further adjustyour withholding allowances based on itemizeddeductions, certain credits, adjustments toincome, or two-earners/multiple jobs situations.AHead of household. Generally, you may claimhead of household filing status on your taxreturn only if you are unmarried and pay morethan 50% of the costs of keeping up a homefor yourself and your dependent(s) or otherqualifying individuals. See Pub. 501,Exemptions, Standard Deduction, and FilingInformation, for information.Personal Allowances Worksheet (Keep for your records.)Enter “1” for yourself if no one else can claim you as a dependent● You are single and have only one job; orTwo earners or multiple jobs. If you have aworking spouse or more than one job, figurethe total number of allowances you are entitledto claim on all jobs using worksheets from onlyone Form W-4. Your withholding usually willbe most accurate when all allowances areclaimed on the Form W-4 for the highestpaying job and zero allowances are claimed onthe others. See Pub. 919 for details.Check your withholding. After your Form W-4takes effect, use Pub. 919 to see how theamount you are having withheld compares toyour projected total tax for 2010. See Pub.919, especially if your earnings exceed$130,000 (Single) or $180,000 (Married).B Enter “1” if: ● You are married, have only one job, and your spouse does not work; or B● Your wages from a second job or your spouse’s wages (or the total of both) are $1,500 or less.CDEFGHFormEnter “1” for your spouse. But, you may choose to enter “-0-” if you are married and have either a working spouse ormore than one job. (Entering “-0-” may help you avoid having too little tax withheld.)CEnter number of dependents (other than your spouse or yourself) you will claim on your tax returnDEnter “1” if you will file as head of household on your tax return (see conditions under Head of household above) EEnter “1” if you have at least $1,800 of child or dependent care expenses for which you plan to claim a credit F(Note. Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.)Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information.● If your total income will be less than $61,000 ($90,000 if married), enter “2” for each eligible child; then less “1” if you have three or more eligible children.● If your total income will be between $61,000 and $84,000 ($90,000 and $119,000 if married), enter “1” for each eligiblechild plus “1” additional if you have six or more eligible children.GAdd lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.) For accuracy,complete allworksheetsthat apply.W-4Department of the TreasuryInternal Revenue ServiceComplete all worksheets that apply. However, youmay claim fewer (or zero) allowances. For regularwages, withholding must be based on allowancesyou claimed and may not be a flat amount orpercentage of wages.Tax credits. You can take projected taxcredits into account in figuring your allowablenumber of withholding allowances. Credits forchild or dependent care expenses and thechild tax credit may be claimed using thePersonal Allowances Worksheet below. SeePub. 919, How Do I Adjust My TaxWithholding, for information on convertingyour other credits into withholding allowances.Nonwage income. If you have a large amountof nonwage income, such as interest ordividends, consider making estimated taxH● If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductionsand Adjustments Worksheet on page 2.● If you have more than one job or are married and you and your spouse both work and the combined earnings from all jobs exceed$18,000 ($32,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 to avoid having too little tax withheld.● If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below.Cut here and give Form W-4 to your employer. Keep the top part for your records.Employee’s Withholding Allowance Certificatepayments using Form 1040-ES, Estimated Taxfor Individuals. Otherwise, you may oweadditional tax. If you have pension or annuityincome, see Pub. 919 to find out if you shouldadjust your withholding on Form W-4 or W-4P.Nonresident alien. If you are a nonresidentalien, see Notice 1392, Supplemental FormW-4 Instructions for Nonresident Aliens, beforecompleting this form. Whether you are entitled to claim a certain number of allowances or exemption from withholding issubject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.AOMB No. 1545-00741 Type or print your first name and middle initial. Last name 2 Your social security number10Home address (number and street or rural route)City or town, state, and ZIP code3Single Married Married, but withhold at higher Single rate.Note. If married, but legally separated, or spouse is a nonresident alien, check the “Single” box.5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2) 5 016 Additional amount, if any, you want withheld from each paycheck NONRESIDENTALIEN6 $7 I claim exemption from withholding for 2010, and I certify that I meet both of the following conditions for exemption.● Last year I had a right to a refund of all federal income tax withheld because I had no tax liability and● This year I expect a refund of all federal income tax withheld because I expect to have no tax liability.If you meet both conditions, write “Exempt” here 7Under penalties of perjury, I declare that I have examined this certificate and to the best of my knowledge and belief, it is true, correct, and complete.Employee’s signature(Form is not valid unless you sign it.) 84 If your last name differs from that shown on your social security card,check here. You must call 1-800-772-1213 for a replacement card. Date Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.) 9 Office code (optional) 10 Employer identification number (EIN)XFor Privacy Act and Paperwork Reduction Act Notice, see page 2. Cat. No. 10220QForm W-4 (2010)

Form W-4 (2010)Deductions and Adjustments WorksheetNote. Use this worksheet only if you plan to itemize deductions or claim certain credits or adjustments to income.Page 21 Enter an estimate of your 2010 itemized deductions. These include qualifying home mortgage interest,charitable contributions, state and local taxes, medical expenses in excess of 7.5% of your income, andmiscellaneous deductions1 $2 Enter:$11,400 if married filing jointly or qualifying widow(er)$8,400 if head of household$5,700 if single or married filing separately2 $3 Subtract line 2 from line 1. If zero or less, enter “-0-” 3 $4 Enter an estimate of your 2010 adjustments to income and any additional standard deduction. (Pub. 919)4 $5 Add lines 3 and 4 and enter the total. (Include any amount for credits from Worksheet 6 in Pub. 919.) 5 $6 Enter an estimate of your 2010 nonwage income (such as dividends or interest)6 $7 Subtract line 6 from line 5. If zero or less, enter “-0-”7 $8 Divide the amount on line 7 by $3,650 and enter the result here. Drop any fraction89 Enter the number from the Personal Allowances Worksheet, line H, page 1910 Add lines 8 and 9 and enter the total here. If you plan to use the Two-Earners/Multiple Jobs Worksheet,also enter this total on line 1 below. Otherwise, stop here and enter this total on Form W-4, line 5, page 1 10Two-Earners/Multiple Jobs Worksheet (See Two earners or multiple jobs on page 1.)Note. Use this worksheet only if the instructions under line H on page 1 direct you here.1 Enter the number from line H, page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet) 12 Find the number in Table 1 below that applies to the LOWEST paying job and enter it here. However, ifyou are married filing jointly and wages from the highest paying job are $65,000 or less, do not enter morethan “3.” 23 If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter“-0-”) and on Form W-4, line 5, page 1. Do not use the rest of this worksheet 3Note. If line 1 is less than line 2, enter “-0-” on Form W-4, line 5, page 1. Complete lines 4–9 below to figure the additionalwithholding amount necessary to avoid a year-end tax bill.4 Enter the number from line 2 of this worksheet45 Enter the number from line 1 of this worksheet56 Subtract line 5 from line 467 Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here7 $8 Multiply line 7 by line 6 and enter the result here. This is the additional annual withholding needed 8 $9 Divide line 8 by the number of pay periods remaining in 2010. For example, divide by 26 if you are paidevery two weeks and you complete this form in December 2009. Enter the result here and on Form W-4,line 6, page 1. This is the additional amount to be withheld from each paycheck9 $Table 1Table 2Married Filing JointlyAll OthersMarried Filing JointlyAll OthersIf wages from LOWESTpaying job are—$0 - $7,000 -7,001 - 10,000 -10,001 - 16,000 -16,001 - 22,000 -22,001 - 27,000 -27,001 - 35,000 -35,001 - 44,000 -44,001 - 50,000 -50,001 - 55,000 -55,001 - 65,000 -65,001 - 72,000 -72,001 - 85,000 -85,001 -105,000 -105,001 -115,000 -115,001 -130,000 -130,001 - and overEnter online 2 above0123456789101112131415If wages from LOWESTpaying job are—$0 - $6,000 -6,001 - 12,000 -12,001 - 19,000 -19,001 - 26,000 -26,001 - 35,000 -35,001 - 50,000 -50,001 - 65,000 -65,001 - 80,000 -80,001 - 90,000 -90,001 -120,000 -120,001 and overEnter online 2 abovePrivacy Act and Paperwork Reduction Act Notice. We ask for the information on thisform to carry out the Internal Revenue laws of the United States. Internal Revenue Codesections 3402(f)(2) and 6109 and their regulations require you to provide thisinformation; your employer uses it to determine your federal income tax withholding.Failure to provide a properly completed form will result in your being treated as a singleperson who claims no withholding allowances; providing fraudulent information maysubject you to penalties. Routine uses of this information include giving it to theDepartment of Justice for civil and criminal litigation, to cities, states, the District ofColumbia, and U.S. commonwealths and possessions for use in administering their taxlaws, and using it in the National Directory of New Hires. We may also disclose thisinformation to other countries under a tax treaty, to federal and state agencies toenforce federal nontax criminal laws, or to federal law enforcement and intelligenceagencies to combat terrorism.012345678910If wages from HIGHESTpaying job are—$0 - $65,00065,001 - 120,000120,001 - 185,000185,001 - 330,000330,001 and overEnter online 7 above$5509101,0201,2001,280If wages from HIGHESTpaying job are—$0 - $35,00035,001 - 90,00090,001 - 165,000165,001 - 370,000370,001 and overEnter online 7 above$5509101,0201,2001,280You are not required to provide the information requested on a form that issubject to the Paperwork Reduction Act unless the form displays a valid OMBcontrol number. Books or records relating to a form or its instructions must beretained as long as their contents may become material in the administration ofany Internal Revenue law. Generally, tax returns and return information areconfidential, as required by Code section 6103.The average time and expenses required to complete and file this form will varydepending on individual circumstances. For estimated averages, see theinstructions for your income tax return.If you have suggestions for making this form simpler, we would be happy to hearfrom you. See the instructions for your income tax return.